Case study:

01 July 2010

The Liverpool Care Pathway Reflective Data Cycle

Key points

Northamptonshire NHS Provider Services have introduced a process of detailed analysis and reflection on the use of the Liverpool Care Pathway as a way of improving the quality of care provided to people in the last days of life.

The LCP Reflective Data Cycle (RDC), which has so far been introduced in several care homes as well as a community hospital and two hospices, has already helped to develop clinical practice, team work and staff skills.

The RDC was introduced in 2008 and aims to facilitate locally driven, continuous quality improvement for dying patients and their families.

The process is repeated at least annually and has five key steps:

1. Data from completed LCPs input onto Excel databases(n=10-20)
2. Evidence-based graphs are formed
3. Data is shared, analysed and reflected upon with the clinical team
4. An action plan is negotiated to address issues raised
5. Action plan is implemented.

The process is overseen by the LCP link nurse from within the care home, supported by the LCP facilitator, who helps them to develop the skills they need to participate in the RDC. The link nurses have as a result gained skills in data input, analysis, presentation and action planning.

The RDC has raised awareness of the LCP as a tool that not only guides, prompts and informs care but enables staff to reflect continuously and build on the care they offer. For example, it helped to highlight some staff concerns over managing difficult conversations which led in turn to training sessions on communications skills. It has also enabled teams to reflect on particular incidents and improve their clinical practice as a result.

It is hoped that more care homes will be encouraged to undertake the RDC in the future.